Table of Contents
Unit I: Medical-Surgical Nursing Settings
- Caring for Medical-Surgical Patients
- Critical Thinking and the Nursing Process
Unit II: Medical-Surgical Patient Care Problems
- Fluid, Electrolytes, Acid-Base Balance, and Intravenous Therapy
- Care of Preoperative and Intraoperative Surgical Patients
- Care of Postoperative Surgical Patients
- Infection Prevention and Control
- Care of Patients with Pain
- Care of Patients with Cancer
- Chronic Illness and Rehabilitation
Unit III: Immune System
- The Immune and Lymphatic Systems
- Care of Patients with Immune and Lymphatic Disorders
Unit IV: Respiratory System
- The Respiratory System
- Care of Patients with Disorders of the Upper Respiratory System
- Care of Patients with Disorders of the Lower Respiratory System
Unit V: Hematologic System
- The Hematologic System
- Care of Patients with Hematologic Disorders
Unit VI: Cardiovascular System
- The Cardiovascular System
- Care of Patients with Hypertension and Peripheral Vascular Disease
- Care of Patients with Cardiac Disorders
- Care of Patients with Coronary Artery Disease and Cardiac Surgery
Unit VII: Neurologic System
- The Neurologic System
- Care of Patients with Head and Spinal Cord Injuries
- Care of Patients with Brain Disorders
- Care of Patients with Peripheral Nerve and Degenerative Neurologic Disorders
Unit VIII: Sensory System
25. The Sensory System: Eye
26. The Sensory System: Ear
Unit IX: Gastrointestinal System
- The Gastrointestinal System
- Care of Patients with Disorders of the Upper Gastrointestinal System
- Care of Patients with Disorders of the Lower Gastrointestinal System
- Care of Patients with Disorders of the Gallbladder, Liver, and Pancreas
Unit X: Musculoskeletal System
- The Musculoskeletal System
- Care of Patients with Musculoskeletal and Connective Tissue Disorders
Unit XI: Urinary System
- The Urinary System
- Care of Patients with Disorders of the Urinary System
Unit XII: Endocrine System
- The Endocrine System
- Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders
- Care of Patients with Diabetes and Hypoglycemia
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Unit XIII: Reproductive System
- NEW! Normal Male and Female Reproductive System Findings
- Care of Women with Reproductive Disorders
- Care of Men with Reproductive Disorders
- Care of Patients with Sexually Transmitted Infections
Unit XIV: Integumentary System
- The Integumentary System
- Care of Patents with Integumentary Disorders and Burns
Unit XV: Emergency and Disaster Management
- Care of Patients in Disasters or Bioterrorism Attack
- Care of Patients with Emergent Conditions, Trauma, and Shock
Unit XVI: Mental Health Nursing of the Adult
- Care of Patients with Cognitive Function Disorders
- Care of Patients with Anxiety, Mood, and eating disorders
- Care of Patients with Substance-Related and Addictive Disorders
- Care of Patients with Thought and Personality Disorders 2 / 4
Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
MULTIPLE CHOICE
- Which statement accurately describes the primary purpose of the state nurse practice act
(NPA)?
- To test and license LPN/LVNs.
- To define the scope of LPN/LVN practice.
- To improve the quality of care provided by the LPN/LVN.
- To limit the LPN/LVN employment placement.
ANS: B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state defines the scope of nursing practice in that state.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 3 TOP: NPA KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that the
- Ask a more experienced nurse to demonstrate the procedure.
- Look up the procedure in the procedure manual.
- Attempt to perform the procedure with supervision.
- Inform the charge nurse of her lack of training in this procedure.
vocational nurse has not been taught during her educational program. How should the vocational nurse respond?
ANS: D
The charge nurse should be informed of the lack of training to perform the procedure, and the vocational nurse should seek further training to gain proficiency. Although the other options might be helpful, they are not safe.
PTS: 1 DIF: Cognitive Level: Application REF: 3 OBJ: 1 TOP: Providing Safe Care KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- Which patient statement indicates a need for further discharge teaching that the vocational
- “I have no idea of how this drug will affect me.”
- “Do you know if my physician is coming back today?”
- “Will my insurance pay for my stay?”
- “Am I going to have to go to a nursing home?”
nurse should address?
ANS: A
Lack of knowledge at discharge about medication effects and side effects is a concern that should be addressed by the vocational nurse. The other concerns in the options are the responsibility of other departments to which the nurse might refer the patient.
PTS: 1 DIF: Cognitive Level: Application REF: 2 OBJ: 1 TOP: Teaching KEY: Nursing Process Step: Implementation 3 / 4
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- According to most state NPAs, the vocational nurse acting as charge nurse in a long-term care
- Working under direct supervision of an RN on the unit
- Working with the RN in the building
- Working under general supervision by the RN available on site or by phone
- Working as an independent vocational nurse
facility acts in which capacity?
ANS: C
The vocational nurse in the capacity of the charge nurse in a long-term care facility acts with the general supervision of an RN available on site or by phone.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 2 OBJ: 1 TOP: Charge Nurse/Manager KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- The nurse is educating a patient that is a member of a health maintenance organization
- Seek the opinion of an alternate health care provider.
- Obtain insurance approval for medical services prior to treatment.
- Provide detailed documentation of all care received for his condition.
- Wait at least 6 months to see a specialist.
(HMO). Which information should the nurse include?
ANS: B
Most HMOs require preprocedure authorization for treatment. Patients are not required to seek a second opinion, provide documentation of care, or wait a specific time period before visiting a specialist.
PTS: 1 DIF: Cognitive Level: Application REF: 9 OBJ: 9 TOP: Charge Nurse/Manager KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- The patient complains to the nurse that he is confused about his “deductible” that he owes the
- An amount of money put aside for the payment of future medical bills
- A one-time fee for service
- An amount of money deducted from the bill by the insurance company
- An annual amount of money the patient must pay out-of-pocket for medical care
hospital. Which statement accurately explains a deductible?
ANS: D
The deductible is the annual amount the insured must pay out-of-pocket prior to the insurance company assuming the cost. This practice improves the profit of the insurance company.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 7 OBJ: 9 TOP: Health Care Financing KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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